NPIMap

Organization Active NPI

Pilsen-Little Village Community Mental Health Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
National Provider Identifier
1821597063
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PILSEN-LITTLE VILLAGE COMMUNITY MENTAL HEALTH CENTER, INC
Practice address
2259 S Damen Ave
Chicago, IL 60608-4232
Phone
(773) 579-0832
Fax
(773) 579-0832
NPI assigned
Feb 2, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Francisco Cisneros
Title
President & Ceo
Phone
(773) 579-0832

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

2259 S Damen Ave
Chicago, IL 60608-4232

Mailing address

2319 S Damen Ave
Chicago, IL 60608-4209
Phone (773) 579-0832

Other identifiers 1

IdentifierTypeStateIssuer
04113MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Pilsen Wellness Center Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

2259 S Damen Ave
Chicago, IL 60608
Phone (872) 281-7574

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1821597063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084209",
            "telephone_number": "773-579-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2259 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084232",
            "telephone_number": "773-579-0832",
            "fax_number": "773-579-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PILSEN-LITTLE VILLAGE COMMUNITY MENTAL HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-02",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "CISNEROS",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_title_or_position": "PRESIDENT   & CEO",
        "authorized_official_telephone_number": "773-579-0832",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04113",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.